高血压并2型糖尿病患者肾损害与心室重构相关性研究  

Relationship between renal damage and ventricle remodeling in patients with diabetes mellitus and hypertension

作　　者：秦春梅[1] 刘波[1] 尹福在[1] 陆强[1] 马春明[1] 吴广飞[1] 

机构地区：[1]河北省秦皇岛市第一医院内分泌科,河北秦皇岛066000

出　　处：《中国现代医学杂志》2011年第24期2985-2988,共4页China Journal of Modern Medicine

基　　金：秦皇岛市科学技术研究与发展指导计划项目(2007028)

摘　　要：目的评价高血压并2型糖尿病患者肾损害与心室重构相关性。方法选取2型糖尿病患者102例,据有无高血压分为糖尿病组（DM组）及糖尿病合并高血压病组（HDM组）。所有研究对象均采用标准方法检测血压、测量身高（m）、体重（Kg）;检测血糖、血脂等生化指标,并于病情平稳时行24 h尿蛋白定量（UTP）检测。采用美国超声心动图协会（ASE）推荐的标准方法测量研究对象的心脏超声相关参数。主要测量舒张期末左室内径（LVD）,舒张期末左室后壁厚度（LVPW）、舒张期末室间隔厚度（IVS）,计算相关参数（左室重量等）以评估左室结构。结果 HDM组肌酐（Cr）、β2-微球蛋白（BMG）、尿蛋白定量（UTP）和尿微量白蛋白（UMA）高于DM组（P〈0.05）,肌酐清除率（Ccr）低于DM组（P〈0.01）,IVS和左室重量指数（LVMI）高于DM组,左室肥厚发生率高于DM组（χ2=4.900,P=0.027）。多元线性回归分析显示,DM组BMI（β=0.954,95%CI0.484~1.424,P=0.000）是LVMI的独立危险因素;HDM组UTP（β=0.004,95%CI 0.002～0.007,P=0.002）是LVMI的独立危险因素。结论糖尿病合并高血压病者存在更严重的肾脏损害,易发生左室肥厚,UTP是左室重量指数（LVMI）的独立危险因素。【Objective】 In this articles,we analysis the echocardiography data of the patients with Diabetes Mellitus and hypertension,to assess the relationship between renal damage and ventricle remodeling in patients with diabetes mellitus and hypertension.【Methods】 One hundred and two cases with T2DM were selected and divided into two groups according to the blood pressure： non-hypertension group（DM）,and hypertension group（HDM）.All patients were collected fasting venous blood to assay biochemical indicator.Patients were observed by Color Doppler echocardiography with left ventricular diastole period end point,left ventricle inner diameter（LV）,left ventricular posterior wall thickness（LVPW） and interventricular septum thickness（IVS） were measured,and left ventricular mass（LVM） according to Dereveux formula were calculated.【Results】 There were significant deference in the value of creatinine（Cr）,β2-microglobulin（BMG）,Urinary total protein（UTP）,urine microalbuminuria（UMA）,IVS and left ventricular mass index（LVMI）,which were all higher in group HDM than group DM,in group HDM,there were higher prevalence of LVH（χ2=4.900,P =0.027）.Multivariable logistic regression analysis revealed that BMI was the only independent correlate of LVMI（β=0.954,95% CI 0.484～1.424,P =0.000） in group DM.Multivariable logistic regression analysis revealed that UTP was the only independent correlate of LVMI（β=0.004,95%CI 0.002～0.007,P =0.002） in group HDM.【Conclusion】 The patients with Diabetes Mellitus and hypertension exist more serious kidney damage and LV remodeling commonly.It indicated that UTP is the only independent correlate of LVMI.

关 键 词：糖尿病 高血压 蛋白尿 心室重构 左心室肥厚 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]